When Your Sciatica Just Wont Quit You Might Have A Misdiagnosed Case Of Piriformis Syndrome
If youre struggling with a chronic pain in the butt, relief can be hard to findespecially if you have piriformis syndrome. The hallmark sign is hip and/or buttock pain on one side of the body along with low back pain that radiates down one or both legs.
Piriformis syndrome can be a real pain in the butt.
The problem is, piriformis syndrome is often mistaken for sciatica. While both conditions interfere with sciatic nerve function, sciatica results from spinal dysfunction such as a herniated disc or spinal stenosis. Piriformis syndrome, on the other hand, occurs when the piriformis muscle, located deep in the buttock, compresses the sciatic nerve.
Your medical providers solid understanding of the structure and function of the sciatic nerve and its relationship to the piriformis muscle is key to distinguishing between true or discogenic sciatica and piriformis syndrome.
Testing For Piriformis Syndrome
Because piriformis syndrome symptoms mimic those of sciatica, your medical provider will perform specific tests to determine whether your symptoms are discogenic or caused by an impingement of the sciatic nerve by the piriformis muscle.
Your provider should examine your low back, hip, pelvis and sacroiliac joint and check your gait, posture and leg length. Theyll also test your reflexes, which should be normal if you have piriformis syndrome.
Your provider will manipulate your leg to check for piriformis syndrome.
Other signs of piriformis syndrome include:
When testing for pain or weakness in specific positions, your provider will conduct each test until you experience symptoms or for up to 60 seconds, whichever comes first.
In addition to a physical exam, you might also need imaging to rule out other causes for your symptoms. Your doctor may order X-rays, an MRI, or a CT scan. In addition, injections into the piriformis muscle may be used to confirm the diagnosis, while simultaneously helping with treatment.
Once you pin down the source of your pain, you can move forward with treatment, which typically consists of NSAIDs and physical therapy. Although you might be inclined to rest, wait, and see what happens, the sooner you find the root of your issues, the sooner you can get back to pain-free living.
Piriformis syndrome or sciatica? Get a proper diagnosis find a spine specialist near you who can help.
What Are Home Remedies For Sciatica
Pain from sciatica often limits one’s activities. Here are some home treatments for sciatica:
- Do not bend, lift, or sit in a soft, low chair the pain will get worse.
- Unless someone is allergic or should not take them for other reasons , over-the-counter pain medicines such as acetaminophen , aspirin , or ibuprofen will probably help ease the pain.
- Try a cold pack to see if it helps the pain. If a cold pack is not available, use a large bag of frozen vegetables it makes a good first aid cold pack. Or have someone massage the sore areas in a triangular pattern with an ice cube. The person should move the ice cube if the skin gets too cold .
- After the cold massages, try alternating with heat from an electric heating pad to see if it helps the pain.
- If an electric heating pad is not available, put a hand towel under hot water, wring it out, and place it on the back. Some physical therapy experts believe that moist heat penetrates more deeply and gives better relief of pain.
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Pain Extending From Your Neck Down Your Arm
Like sciatica, nerve compression in the neck portion of your spine occurs when a nerve in your neck becomes compressed or pinched when it leaves your spine to travel down your arms or into your shoulders. Irritation of a cervical nerve can cause pain and similar symptoms anywhere along the nerve pathway, including your shoulders, the very upper part of your back, your arms, and even your hands.
Treat Sciatic Nerve Pain At Midamericas Palos Hills & Mokena Locations
Sciatica is a term describing the symptoms of leg pain originating in the lower back, traveling through the buttock and down the sciatic nerve located at the back of each leg. The sciatic nerve is the largest single nerve in the body, made up of individual nerve roots branching from the spine in the lower back.
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How Is Foot Drop Diagnosed
To diagnose foot drop, the doctor will do a physical examination and ask you about your symptoms. The doctor will also want to see how you walk, and will examine your leg muscles for any weakness or damage.
The doctor may order certain tests, including the following:
- Imaging tests, including X-rays, ultrasound, and MRI and CT scans, to look for injuries to the legs, spinal cord, or brain
- Blood tests to check blood sugar levels, and to look for any potential toxins that could be causing the condition
- Nerve conduction tests to examine how the nerves are functioning
- Electromyography, a test in which electrodes are placed in the muscles of the legs to measure their electrical activity .
Q: What Is The Relationship Between Core Strength And Back Pain
Theoretically, if your muscles around the low back are weak, your body will rely more on passive structures for stability, including ligaments the tissue that connects bone to bone as well as the spinal bones or discs which lie between the spinal bones. This can cause pain.
But some studies have shown that specific core exercises are not any more beneficial than general exercise for low back pain. What we know is that exercise in general can help, and focusing on core muscles may provide some additional benefit.
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Taming The Pain Of Sciatica: For Most People Time Heals And Less Is More
- By Steven J. Atlas, MD, MPH, Contributor
Despite being a less common cause of low back pain, sciatica is still something I regularly see as a general internist. Primary care doctors can and should manage sciatica, because for most individuals the body can fix the problem. My job is to help manage the pain while the body does its job. When a persons symptoms dont improve, I discuss the role of surgery or an injection to speed things up.
How Is Foot Drop Treated
Treatment for foot drop depends on what is causing it. Treatment options include the following:
- Exercises to strengthen the lower leg muscles
- Orthotics: An orthotic is a lightweight device that is worn on the ankle and lower leg to keep them straight. The doctor may also recommend orthotic shoe inserts.
- Electrical nerve stimulation: Electrodes are placed on the lower leg and connected to a small pack that the patient wears on his or her hip. The pack sends impulses to the electrodes to cause the nerves in the lower leg to shorten, which helps lift the leg. In some cases, the electrodes are implanted in the patients leg through surgery.
- Surgery: A tendon can be transferred from the other leg to the muscle in the affected leg to help it pull the foot up. If foot drop is permanent, your doctor may recommend surgery to fuse your foot and ankle joint.
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Symptoms Of Sciatic Nerve Pain
The primary symptom, as mentioned above, is pain that starts in your lower back and radiates down your legs. Some other symptoms could point to sciatic nerve pain, though:
- Leg pain
- Numbness, tingling, or pins and needles in your legs
- Burning sensation in your lower extremities
- Pain that worsens with coughing, moving, or sneezing
If you experience any of these symptoms, you should let your doctor know at your next appointment. Theyll be able to provide some safe ways to relieve your pain or some over-the-counter pain medicine. Until then, here are some great stretches you can try at home to ease the pain.
Southern Cross Medical Library
The purpose of the Southern Cross Medical Library is to provide information of a general nature to help you better understand certain medical conditions. Always seek specific medical advice for treatment appropriate to you. This information is not intended to relate specifically to insurance or healthcare services provided by Southern Cross. For more articles go to the Medical Library index page.
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Different Types Of Bowel Movements
The way your bowel movements look can tell you a lot about how your gastrointestinal tract is performing.
Nurse Hatty illustrates in this YouTube video, the shape of your poop can indicate whether you are experiencing healthy or unhealthy gut functions.
The Bristol Stool chart, as she demonstrates, shows the seven different types of bowel movements.
According to the Bristol Stool Chart, you will have one of the seven following types of bowel movements:
1. Hardened, separate lumps 2. Lumpy and sausage-shaped stool 3. Sausage-like stool with tiny cracks in the surface 4. Smooth and snake-like 5. Softened blobs with clearly-defined edges 6. Mushy-looking with jagged edges 7. Liquidy and lacking any solid areas
Additionally, stool color can be a good sign of gut health. As Dr. Benjamin Wedro points out, a healthy bowel movement should be light to medium brown in hue.
Some mild changes in color are actually normal and shouldnt raise any red flags concerning your health.
Changes in your diet and/or medication intake can cause your stool to change colors.
Iron supplements, for example, are known to cause blackened stool, especially when taken at high dosage levels.
However, dramatic changes in stool color can be linked to certain conditions, such as Crohns disease, Celiac disease, and Diverticulitis.
Stool that is red or black in color could indicate that there is bleeding happening somewhere in the gastrointestinal tract and should be addressed by your doctor.
Q: When Should You Talk To A Doctor About Your Back Pain
If any of the following is going on you should consult with your doctor:
- Your pain has been going on for longer than a month, despite resting from activities that make it worse.
- Your pain is getting worse.
- Your pain wakes you from sleep.
- Your pain is in your low back but also is going down one or both of your legs.
- You notice that one leg is becoming weaker than the other.
Q: Where should you turn if you want help in creating a plan to address back pain?
Physical therapists train as musculoskeletal experts they are the experts on muscles, bones and human movement. These professionals are the most qualified, aside from an orthopedic doctor, to assess back problems.
Since there are many factors that impact low back pain and many types of low back pain, it is a good idea to visit at least one time with a physical therapist for an evaluation and subsequent plan of care. This will give you an individually tailored plan with exercises that progress safely. The idea of core strengthening, while beneficial, is just one piece of the low back pain puzzle.
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What Does Sciatic Nerve Pain Feel Like
Sciatica is when the sciatic nerve gets inflamed and becomes painful. The sciatic nerve runs from your hip to your foot and can cause hip, lower back and buttock pain. It is the longest and widest nerve in the body. It also controls many muscles in the lower legs and is important for feeling sensations in the lower leg and foot. People with sciatica can have pain that lasts from a couple of weeks to long periods of time. If left untreated, it can have adverse consequences on health.
Symptoms of sciatica pain include:
- Tingling like pins and needles
- Pain that may feel like shooting, stabbing or burning sensations
Sciatica symptoms may worsen when moving rapidly, such as when coughing or sneezing. Without treatment, pain in the middle lower back and buttocks will persist and can worsen. This is why it is important to consult a pain management physician to examine the causes and determine the best treatments for your lifestyle.
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A Simple Understanding Of Sciatica What Does Sciatica Feel Like
First a huge and important disclaimer. I am not in any way medically qualified, and do not pretend to be. Everything I say is from a viewpoint of a person with 10 years-worth of sciatica suffering. I have tried to write accurately but I cannot guarantee I have got everything right. Im very happy for physiotherapists, or other clinicians, to put me right on anything!
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Preventing Sciatic Nerve Pain
While sciatica may not be completely avoidable, there are certain ways to protect your back from recurring pain:
- Regular Exercise: Keeping your back strong and paying attention to core strength in the abdomen and lower back are essential for proper alignment.
- Maintain Good Posture When You Sit: Sitting with lower back support, armrests, and a swivel base help your posture. Keep you knees and hips level, and consider adding a small pillow in the small of your back to maintain its normal curve.
- Be Mindful of Good Body Mechanics: Be mindful of your body while doing regular daily activities and if you do physical labor for work. If you stand for a long time, alternate propping your feet up on a small box from time to time. When lifting something heavy, use your knees instead of relying on your back keep your back straight and bend at the knees. Get help lifting large items so you dont stress your muscles or joints.
Straight Leg Raise Test
The straight leg raise test determines the source of your pain. The test stretches the sciatic nerve and, if its compressed, the symptoms will occur.
- Lie flat on your back with your legs extended.
- Flex your foot and lift your leg 30 to 70 degrees upwards, keeping your leg straight.
- Repeat with the other leg.
If you experience pain down your leg to your foot or are unable to lift your affected leg as much as the other, this is a positive sciatica test result. If no pain occurs, the test is considered negative and any pain youre experiencing may be due to other spinal conditions.
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What Should I Avoid Doing If I Have Sciatica
Avoid putting added pressure onto your lumbar spine and sciatic nerve as much as possible. Activities such as sitting with bad posture, heavy lifting, difficult or strenuous exercise, and sitting or laying down for prolonged periods can aggravate your body.
Be sure not to rest too much when you have sciatica, as your back can weaken and worsen your pain. With this in mind, dont ignore your pain signals or fight through them. Taking a few minutes to sit down and let your pain pass is perfectly okay.
Sciatica Is Nerve Pain
There are a series of nerve roots that exit from your lower spine. When any of these nerve roots on either side of your lower spine becomes irritated or pinched, pain may radiate from the nerve root to the sciatic nerve. The pain may travel down the sciatic nerve through the buttock and down the back of the leg and into your foot and/or toes. It typically occurs only on one side of the body.
The pain is unique often described as a shooting, searing pain that is felt deep in the buttock and radiates down the back of the leg. Numbness, tingling, or burning may also be felt along the nerve. Some people describe the nerve pain as electric-like. Conversely, sciatica symptoms may be experienced as more of a constant, dull pain.
Medical terms used for sciatica include lumbar radicular pain and lumbar radiculopathy.
Many people refer to any type of leg pain as sciatica, but in fact, there are many causes of leg pain that are not medically classified as sciatica and need to be treated differently.
Examples of problems that are not sciatica but can cause similar symptoms include:
- Joint problems in the spine. Pain may be referred from the spinal joints down into the leg. This problem is technically not sciatica, and the treatment for it is different. For example, joint degeneration from spinal arthritis may cause pain that has sciatica-type symptoms.
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Nonsurgical & Conservative Treatments
Simply put, there are numerous conservative treatment options for people who suffer from sciatica. Some of the most common examples are:
- Heat/Ice: For more isolated and less severe instances of pain, heat/ice pack application helps to remedy pain and discomfort. It is best to apply this method in 20-minute increments, every two hours. Whether or not you decide to use heat or ice is entirely up to your preference, so you should experiment with both. If you decide to use ice, make sure to protect your skin with a towel or cloth to avoid skin irritation.
- Pain Medications: Over-the-counter and prescription medications may help to alleviate the pain associated with sciatica. More specifically, oral steroids or NSAIDs can reduce inflammation and muscle relaxants work to relieve aches and spasms. Narcotic medications may also help with pain relief in cases where muscle relaxants do not work. In more severe cases, however, your doctor may prescribe epidural steroid injections. This solution, however, is often temporary and must be repeated about every 6 months.
- Physical Therapy: It is best to do your research or consult a therapist for advice on the best pain-relieving exercises. Cautious experimentation with strengthening, stretching, and low-impact aerobic exercise will help you find what works best for you.